HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCE=PTED
Date. ` ! Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address
Legal Description: h��%'�
#a
Property Tax ID #: — �i ��i Lot No.
,z
Site Plan Name:
Block No. d '
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name....
Name: JOSEPH FTULLY
Additional Work to ffr orme un ert
mis perit— c ec
a hatappHVAC
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
Gas Tank
FIGas Piping
I =1
Shutters
Windows/Doors
Fill in fee simple Title Holder on next page (if different
F]
Electric 0 Plumbing
[]
Sprinklers
Generator
F]
Roof
Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ I � �, ( ;10 Utilities:Sewer 7Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name....
Name: JOSEPH FTULLY
Company: GENESIS PLUMBING SERVICES INC
Address sg t�." "' i°F��w
City`. � �- ;, I. ,, � State: F
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
City: PORT ST LUCIE State: FL
Zip Code: �� Fax:
Phone N�•`� - - g,�
Zip Code: 34952 Fax; 772-335-2680
Phone No. 772-337-3682
E -Mail:
Fill in fee simple Title Holder on next page (if different
E -Mail: genesisplumbingservices@gmaii.com
from the Owner listed above)
State or County License: CFC1429103
If value of construction is 5Z500 or more, a KtLUKEJtU iMot.ce v1 .- i -I...—
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
'Signature of Owner/: seejtontractor as Agent for Owner
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTY OF
The fo ri,ng instrument was acknowledgeri before me
this 4 A"f`dayof._.'. 201i by
c, r-voF,
(Name of person acknowledging)
ature of Notar Public- State Florid _
(Sign y rids)
-, uuatu"ai'� Pr e18ti�C�rZ
Personally Known
Type of Identificati Commission # GG 97150
"ss ,ca y Commission Expir
24 2021
Commission No.
Revised 07/15/2014
The for ing instrument was acknowledged before me
this '' `°day of 20 n by
(Name of person acknowledging )
Signature of Notary Public- State of Florida
Personally Known PrqApAei1�P1�TcZ
Type of Identificati o "stl Commission # GG 97150
-
- My Commission Expires
April
021
Commission Na n "
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